Jt Comm J Qual Improv. 1998 Oct;24(10):549-65. doi: 10.1016/s1070-3241(16)30403-5.
Health systems and clinics in San Diego have joined with public health and academic representatives to develop collaborative, innovative, and effective ways to address the region's ever-increasing health care needs. Community Health Improvement Partners (CHIP) was established in a local environment with a highly developed managed care marketplace, a diverse county population, no public hospital, and a growing number of uninsured. The catalyst for the 25-member CHIP coalition was 1994 legislation that required not-for-profit, private hospitals to, among other things, conduct a health needs assessment of its community (every three years) and prepare a community benefit plan and report (annually). After the production of the needs assessment, members implemented a priority-setting process and a combined countywide community benefit plan.
Of 12 self-managed work teams formed in 1996, 7 are still meeting in some capacity--addressing access to care for the underinsured and uninsured, chronic disease management in underserved areas, community diabetes care, health education and access to care for African immigrants (new Americans), adolescent health, mental health, and violence prevention.
The participation of the full spectrum and variety of health care stakeholders at the table, unique to San Diego, has enabled CHIP to serve as an open forum for frank discussions of critical and, at times, controversial health care issues.
The difficulties with collaboration are not be to be minimized. CHIP hopes to live up to its aspirations to make a difference through accomplishments that are cost-effective to truly improve the health of San Diego residents.
圣地亚哥的医疗系统和诊所已与公共卫生及学术代表携手合作，以开发协作性、创新性且有效的方式，来满足该地区日益增长的医疗保健需求。社区健康改善伙伴组织（CHIP）是在当地环境中成立的，这里有高度发达的管理式医疗市场、人口多样的县、没有公立医院，且未参保人数不断增加。由25名成员组成的CHIP联盟的催化剂是1994年的一项立法，该立法要求非营利性私立医院除其他事项外，（每三年）对其社区进行一次健康需求评估，并（每年）制定一份社区福利计划和报告。在完成需求评估后，成员们实施了一个确定优先事项的过程以及一项全县范围的综合社区福利计划。
CHIP工作团队：1996年组建的12个自我管理工作团队中，有7个仍在以某种形式开会——解决未充分参保和未参保人群的就医问题、服务欠缺地区的慢性病管理、社区糖尿病护理、健康教育以及非洲移民（新美国人）的就医问题、青少年健康、心理健康和预防暴力。
圣地亚哥特有的情况是，各类医疗保健利益相关者都参与其中，这使得CHIP能够成为一个公开论坛，用于坦率讨论关键且有时颇具争议的医疗保健问题。
合作中的困难不可小觑。CHIP希望通过实现具有成本效益的成果来真正改善圣地亚哥居民的健康状况，从而不辜负其有所作为的抱负。
